Moxibustion as an adjuvant therapy for heart failure: A systematic review and meta-analysis of a randomized controlled trial

Abstract Background Moxibustion as an adjuvant therapy shows clinical efficacy in the treatment of heart failure (HF). However, there has been a lack of overall evaluation of the efficacy of moxibustion. Objective To evaluate the efficacy and safety of moxibustion combined with conventional drug therapy, and the quality of evidence regarding its use for preventing ventricular remodeling, improving cardiac function, and improving the prognosis of patients with HF. Method Search the keywords moxibustion therapy and HF from 7 databases. EndNote X8 software was used for literature management. RevMan 5.4.1 software was used to summarize data, and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of research. Results A total of 910 patients were included from 11 studies. Meta-analysis showed that compared with the control groups, patients treated with moxibustion had significantly improved 6-min walk experiment (6-MWD) scores (mean difference [MD] = 57.39, 95% confidence interval [CI] [39.49 to 75.30], P < 0.01) and left ventricular ejection fraction (LVEF) scores (MD = 4.93, 95% CI [3.12 to 6.74] for patients with HF, P < 0.01),According to GRADE, those using LVEF, Lee's HF score, and BNP were “moderate quality” and others were “low quality” or “very low quality.” Conclusion Studies suggest that moxibustion is a safe adjuvant treatment that can improve the cardiac function and prognosis of patients with HF. However, owing to the small sample sizes used in previous studies and the low quality of evidence, these results need to be further verified.